| Theme | Patient Management During Endoscopic Examination and Treatment | |
|---|---|---|
| Title | Management for Colonic EMR or ESD | |
| Publish Date | 2012/09 | |
| Author | Shiko Kuribayashi | Endoscopy Division, National Cancer Center Hospital |
| Author | Humihiko Nakamura | Endoscopy Division, National Cancer Center Hospital |
| Author | Taku Sakamoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Yosuke Otake | Endoscopy Division, National Cancer Center Hospital |
| Author | Takeshi Nakajima | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospital |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] | Endoscopic submucosal dissection (ESD) for colon cancer has been approved by the medical insurance system in Japan. Compared with ESD for esophageal or gastric cancer, there are some differences for management of patients during colonic ESD procedures. Deep sedation should not be administered since changing patientʼs body position is important and holding their breath is sometimes useful for safe and effective ESD. Adequate bowel preparation is also essential for safe ESD. In addition, carbon dioxide insufflation is necessary to reduce patientsʼ pain and discomfort during and after ESD procedures. Moreover, carbons dioxide insufflation may prevent patients from experiencing critical conditions when perforation occurs. It has been shown that carbon dioxide insufflation is safe therefore, monitoring carbon dioxide levels may not be necessary during ESD procedures except for COPD patients. | |